Bring your RN expertise to a mission-driven team supporting medical claim reviews with accuracy, compliance, and compassion. This is a full-time, work-from-home opportunity with preference for candidates living in HUBZone areas.
About Broadway Ventures
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) delivering program management, technology, and consulting solutions. Built on collaboration, integrity, and excellence, the company empowers clients across government and private sectors to achieve operational success, sustainability, and innovation.
Schedule
- Full-time, Monday–Friday, 8:00 AM – 4:30 PM EST
- Remote, with high-speed internet and a private home office required
- Must be able to travel to Augusta, GA office ~4 times per year
- Preference for candidates in South Carolina or Georgia
What You’ll Do
- Conduct pre-pay and post-pay claim reviews (radiology, ambulance, PT, surgical, etc.)
- Evaluate medical necessity, appropriateness, and reimbursement decisions
- Document medical rationale for payment or denial of services
- Educate staff on medical reviews, terminology, coverage, and coding procedures
- Participate in quality control, audits, and special projects as needed
- Provide guidance to LPN team members and support education for non-medical staff
What You Need
- Active, unrestricted RN license (compact multistate RN license preferred)
- Bachelor’s degree in Nursing required; Master’s strongly preferred
- 5+ years clinical RN experience (medical-surgical, home health, or rehab)
- 2–3+ years utilization/medical review, quality assurance, or home health experience
- Strong knowledge of managed care, healthcare delivery systems, and criteria/protocol sets
- Proficiency in Microsoft Office; ability to handle multiple systems/screens simultaneously
- Excellent communication, critical thinking, and decision-making skills
- HUBZone residency preferred (check SBA.gov HUBZone map)
Benefits
- $67,700/year salary
- 401(k) with employer match
- Medical, dental, and vision insurance
- Life and disability insurance
- Flexible Spending Account (FSA)
- Paid time off + holidays
- Remote work flexibility with occasional travel
Broadway Ventures values diversity and is an equal-opportunity employer. Accommodations are available for applicants with disabilities.
Happy Hunting,
~Two Chicks…